Ask the Coder (537)

Without more specific information your best and most accurate code would be D5281

If you are billing to the dental carrier you would use D7240 and note in the remarks area of the CDT form this is a supernumerary tooth. You should also include an x-ray along with the claim.

Question 1: No you may not charge an additional charge for the wax work-up it is considered inclusive of the initial procedure. Question 2: No you may not pass the expense onto the patient. The lab fees may not be charged in addition to the initial procedure.

There is no CPT code for D6056 as medical carriers do not cover the prosthetic portion of a dental implant...you may however try to use 99002 (delivery and handeling).

CPT code 41899 is to be used and listed seperately for each tooth with ICD-9-CM code 520.6. In box 19 you need to put the dental code along with the tooth number...example Teeth involved D7230 #1 & #17, D7240 #16 & #32

Spacers are not billable procedures they are considered inclusive of another procedure. Usually space maintainers or orthodontia services.

By spacer band we are assuming you are referring to a space maintainer? Is that correct? If so you would use CDT codes D1510-D1525; Depending on if the space maintainer is fixed or removable.

The most accurate code would be CDT D7998

Since there is no current code listed for zirconia crowns depending on the carrier they will request CDT code D2999 and a narrative as to the "medical necessity" of this material rather than a standard crown. Some carriers will allow CDT code D2783, however, you will need to check with your carriers utilization review guidelines (more)

No! Whatever procedure the doctor performs must be within his contratual guidelines. Meaning if he charges the patient an extra fee he must report that fee to the carrier, otherwise, this maybe considered a form of fraud.